All living creatures die. The way of death is of great
interest to humans and in part determines the way of life. Birth is not a
choice but dying can be elected as a free and rational choice for a number of
reasons. In general, a healthy, modern human will opt for life and will imagine
death as an appropriate, peaceful outcome of aging sometime in the distant
future. Nevertheless, death may come abruptly, prematurely, unfairly, violently
and sometimes cruelly.
Humans are preoccupied with constructions, beliefs and
rituals designed to appease spirits associated with death and provide guidance
to survivors. Funeral rituals can be elaborate and prolonged, often specifying
the behaviors that are expected of survivors. Death is the acknowledgement
among the living often with confusion, fear, screaming and weeping. The crisis
of death is that one human has vanished from the group and will never return.
If the dead human was loved and valued, then the loss is great and the grief is
painful and prolonged.
Death is the
gathering of the kin to grieve, to celebrate, and to fight over inheritance
rights and kin status. Beliefs in destinations after death are common and, in
the best case, reassure survivors that their loss will be redeemed.
Grief, like love, is a complex of feelings, emotions,
memories and thoughts. Grief inspires
the deepest inquiries into the nature and meaning of existence. Even the
distress of talking about grief reminds us that this complex of feeling,
memories and thought is an important regulator of human affairs. As soon as you
care about someone else, you incur the risk of losing him or her. If you become
complacent over time, watching the suffering of others who have lost a loved
one is a powerful reminder to be more careful. The prospect of grief is so
daunting that humans who care for one another are more concerned and cautious
in their custodial role, protecting loved ones.
People who have experienced a loss or near-loss will often declare that
they became more appreciative of those around them. Pure, pristine grief is our
response to death. There is an initial emotional state with "outpouring of
emotion". The expression is unmistakable in many cultures - crying,
wailing, self-injury and self-neglect. The passionate stage of grief tends to
last hours to days. When a loved one dies,
grief is inevitable but the onset may be delayed. A sudden death is especially
confusing, hard to believe and impossible to accept. A state of suspended
disbelief may last for days or weeks, but sooner or later, grief explodes as
the terrible truth is realized with clarity. The emotional expression of grief
may be ritualized and dramatized as part of funeral observances. Grief often
emerges overtime with sustained dysphoric feelings.
Sadness is a subdued expression of grief that may last for
years or even a lifetime. Sadness is
both a feeling of loss and withdrawal from life involvements. There is a
gradation of sadness from mildly uncomfortable feelings expressed by poems and
little tears to despair. The deep, impenetrable sadness of someone grieving the
loss of a person truly loved is one of the hallmarks of sentient life on earth.
Some humans do not survive their grief because the sadness is so profound.
There is a tendency for humans to want to live forever when
things are going well. The idea of immortality appeals to the young and
healthy. Most observers stipulate that they would only want to live on as a
youthful, healthy person. The idea of reaching 90 years of age and then
extending life for another 100 years is not so appealing. Thus, younger people
tend be more interested in immortality than older people, although there are
always exceptions. Older people want to be rejuvenated. The grand view of life
on earth does not place individual values first but the places the continuation
and evolution of life first. Individuals die so that younger individuals can
replace them. Life goes on. Living creatures are programmed to die. Individual
cells die both in a programmed mode and an incidental or accidental mode.
Programmed cell death is essential for the survival of whole organisms. Cells
that become immortal run amok, proliferate relentlessly and kill the host.
Immortal cell growth is referred to as cancer.
The longest lifespan is determined in advance and the
challenge of survival is to live through the maximum time permitted. The slow
deterioration, aging, proceeds in gradual steps. Aging and disease merge
inevitably as the deterioration of the body provides more opportunity for
disease processes to flourish. Because aging is programmed, there is some
interest among life scientists to discover how to prolong life. There are
tantalizing clues to the mechanisms behind the aging processes, but attempts to
alter this process may have adverse consequences. Cancer cells, for example,
have escaped aging and are immortal. The reason that cancer cells kill you is
that they keep reproducing when they should stop. Programmed cell death is one
of the basic strategies of getting trillions of cells to live together in a
cooperative enterprise. You can extend this insight to populations of animals
of planet earth. If all the humans and all the animals became longer lived,
then you all have to stop reproducing or all would perish in an unprecedented
population explosion.
Death is understood
as the cessation of breathing and of heart beating. Death is also understood as
deep sleep, the lack of movement, the lack of response to words, gestures, and
touches. Death is the distress that living people experience when they witness
the cessation of living movements in another human and view the rigidity of a
corpse. Death has become more abstract in hospitals where detailed measurements
and monitoring of vital functions are available. Death can be anticipated by
the measurement of body chemistry, by monitoring the function of vital organs
and by applying statistics gathered about the natural course of diseases. Information about disease processes is linked
to individual and group concepts about the “quality of life.” The challenge is
pursue treatments that promise improved quality and duration of life without
accepting futile treatments that just prolong suffering. Discussions about the inevitability of death
are now more common and decisions about offering or withholding treatment are
now linked to understanding disease processes and they way they cause death.
Death can now be determined as brain damage with the permanent loss of
consciousness. The rest of the body can be intact and functioning well. What
every neurologist knows is that if a small lesion is made in the ascending
reticular activating system of the medulla oblongata or midbrain, consciousness
is lost and may never be regained.
This view is practical - consciousness can be destroyed by
damage to specific and tiny areas of the old brain. The brain often swells in
head-injured patients and compress its own blood supply. A patient may be an
otherwise healthy, attractive teenager with a head injury who looks quite
viable, but if perfusion scans of the brain show no blood supply to the
cerebral hemispheres, the recovery of consciousness and sentient functions is
unlikely and death is declared. The emergence of free, individualistic,
affluent societies is associated with the disappearance of elaborate death
rituals and well-specified roles for each community member to play. Funerals
are often perfunctory or omitted and dead bodies pass through impersonal,
professional hands leaving survivors with thoughts and feelings disconnected
from any experience that might make the death of another more real and more
acceptable. Acceptance of death for what
it is– the end of an individual life - is difficult to achieve but once there,
we can more or less live peaceably with the idea. We have no obligation to like
the truth. Acceptance is quite different from liking.
Since life involves suffering, there are times when death
seems an attractive way out. The Japanese Samurai tradition advocated killing
oneself in a deliberate ritualistic manner as an honorable and correct choice
when adverse circumstances prevail.
Voluntary death becomes a noble act that requires courage and skill and
a formal acknowledgement of the ephemeral essence of all life. In a less noble
fashion, Japanese Kamikaze pilots during the Second World War volunteered for
suicide missions just as suicide bombers today wear dynamite vests and kill
others as they kill themselves.
In the romantic western tradition, killing oneself has
sometimes been viewed as a legitimate lover's response to the loss of his or
her beloved and an understandable response to a major loss of investment, power
or prestige. Self-inflicted death is also acceptable to avoid capture,
imprisonment or torture. Selecting the right time of death is also a freedom
often denied to the terminally ill. A person with advanced cancer who suffers
every day with no hope of recovery will decide that the experience is too
unpleasant; it is time to leave. It is easy to argue that dying is a legitimate
choice among choices for a free sentient being, but in many countries today,
distant moral authorities and laws ban self-inflicted death under any
circumstance.
Acceptance, in part, comes from the full participation in
the death of another, caring for the body, calling kin and friends together to
share stories and ritual observances, crying, preparing the body for burial,
and disposing of the body in a meaningful way. Anthropologists continue to
discover evidence of hominin ritualistic burials thousands of years ago that
show care and attention in placing the body, covering the body with flowers and
leaving gifts and tools. The attention to burial is an expression of the
survivors feeling of loss and their continuing need to care for themselves.
Death in a group is a reminder to all that each person is vulnerable. Grieving,
in the best case, enhances the survivor’s awareness of the value of others. In
grief, there are intense moment of feeling the great paradox of being alone and
yet, needing to be together.
From my selfish point of view, aging, sickness and death are
bad ideas. If someone were responsible for these bad ideas, I would seek them
out and complain. I find it odd when
people believe in an interactive God who kills a bunch of nice people in a plane
crash and their relatives gather to address this "merciful god" and
ask for his blessings. They sue the airline and praise God. If God had a known
address, I think I would sue God as well.
Acceptance is realizing that there is no complaints
department in the universe. I accept that death is the end of individual
consciousness and the contents of one mind vanish. No personal biographical
information is transmitted to another brain, young or old. No soul goes to
heaven. There is no heaven. There is no hell.
The person who dies lives on in the minds of the people who
knew him or her. It is the survivors who create the stories that keep the
deceased person alive. They archive letters, photos and other artifacts.
Sometimes, the survivors say the person has been reborn and celebrate a child
who will carry on in the mindset of the deceased. Sometimes, the survivors say
that the person has gone for an extended vacation in an unknown location, all
expenses paid by God, Jesus, Mohammed, Moses or some other philanthropist in
the sky.
From Human Nature by Stephen Gislason MD
From Human Nature by Stephen Gislason MD